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Off-pump coronary artery bypass. Mid-term results
A Amano1, H Hirose, A Takahashi
1Department of Cardiovascular Surgery, Shin-Tokyo Hospital, 473-1 Nemoto, Matsudo City, Chiba 271-0077, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|March 10, 2001
Summary
Off-pump coronary artery bypass grafting (CABG) offers acceptable in-hospital and mid-term outcomes, demonstrating safety without cardiopulmonary bypass. However, long-term cardiac events may be linked to incomplete revascularization.
Area of Science:
- Cardiac Surgery
- Cardiovascular Research
- Minimally Invasive Procedures
Background:
- Off-pump coronary artery bypass grafting (CABG) on a beating heart is a growing procedure in cardiac surgery.
- Initial outcomes for off-pump CABG have been promising, necessitating further evaluation of its efficacy.
- This study reports on the early and mid-term results of off-pump CABG performed at Shin-Tokyo Hospital.
Purpose of the Study:
- To evaluate the early and mid-term clinical outcomes of off-pump coronary artery bypass grafting (CABG).
- To compare the results of off-pump CABG with conventional on-pump CABG.
- To assess the safety and efficacy of performing isolated CABG without cardiopulmonary bypass.
Main Methods:
- Retrospective review of medical records for patients undergoing off-pump or on-pump CABG between September 1, 1996, and August 31, 1999.
- Classification of off-pump CABG patients into MIDCAB (minimally invasive direct coronary artery bypass) and OPCAB (off-pump CABG via sternotomy) groups.
- Collection and analysis of preoperative, perioperative, and follow-up data, including graft patency and survival rates.
Main Results:
- Off-pump CABG (194 cases) showed significantly shorter intubation times, ICU stays, and hospital stays compared to on-pump CABG (995 cases).
- The off-pump group had no in-hospital deaths and fewer major complications than the on-pump group.
- Graft patency rate was 98.6% in the off-pump group; 36-month survival was comparable (94.6% vs. 95.2%), but event-free rates were lower (84.0% vs. 88.0%).
Conclusions:
- Off-pump CABG demonstrates acceptable in-hospital and mid-term results, confirming its safety for isolated CABG without cardiopulmonary bypass.
- Advancements in coronary stabilization techniques have likely contributed to the improved outcomes observed in off-pump procedures.
- Potential long-term cardiac events in the off-pump group may be associated with incomplete revascularization, warranting further investigation.